Eligibility & Verification- Executive

About Job Role:

● Review and verify client information to determine eligibility for specific

benefits or programs.

● Communicate with clients or relevant parties to gather necessary information.

● Verify and analyse insurance coverage details, including co-pays, deductibles,

and coverage limits.

● Determine the extent of benefits available to clients based on their eligibility

status.

● Maintain accurate and up-to-date records of client information, eligibility

status, and benefit details.

● Document verification processes and outcomes for future reference.

● Communicate eligibility and benefit information to clients, colleagues, or

relevant stakeholders.

● Provide clear explanations of benefits, coverage details, and any necessary

actions required.

● Address and resolve any discrepancies or issues related to eligibility or

benefits.

● Collaborate with other departments or teams to ensure accurate information

flow.

● Stay informed about relevant laws, regulations, and industry standards related

to eligibility and benefits.

● Ensure compliance with all applicable guidelines and policies.

● Provide excellent customer service by responding to inquiries, addressing

concerns, and assisting clients in understanding their benefits.

● Any graduate or equivalent; additional education or certifications in healthcare administration or related fields may be preferred. ● Previous experience in eligibility verification, benefit analysis, or a similar role. ● Knowledge of insurance policies, financial assistance programs, or relevant benefits. ● Strong attention to detail and accuracy. ● Excellent communication and interpersonal skills.